07D2229417 CLIA NUMBER - WALGREENS # 19944

Laboratory Demographics

CLIA Number: 07D2229417

Facility Name: WALGREENS # 19944

Facility Address:
71 PALOMBA DR
ENFIELD, CT
ZIP 06082
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Facility Phone Number: 860 749-4184

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1124541966

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	07D2229417
LAB Type	Pharmacy
Facility Name	WALGREENS # 19944
Street	71 PALOMBA DR
City	ENFIELD
State	CT
ZIP	06082
Phone	860 749-4184
CertificateType	4
CertificateEffectiveDate	7/12/2023
CertificateExpirationDate	7/11/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024